Cryocoagulation and scleroplasty in complicated diabetic retinopathy

Abstract

Seventy-two patients with insulin-dependent diabetes mellitus were treated at Endocrinology Research Center. The mean age of patients was 28.5 years, duration of diabetes 12-31 years. The majority of patients presented with decompensated diabetes and drastic 24-h fluctuations of glycemia. Mean level of glycated hemoglobin in these patients was 10.6 ± 4.9%.

Transconjunctival cryocoagulation was carried out in 48 patients (64 eyes) with coarse proliferative changes in the fundus oculi, growth of new vessels into the vitreous, and frequent repeated hemorrhages into the vitreous. Posterior pole scleroplasty and transscleral cryocoagulation were carried out in 24 patients (46 eyes) with coarse exudative proliferative changes in the fundus oculi and partial traction detachment of the retina.

Vision improved the next day after transconjunctival cryocoagulation in 18 patients out of 48. Objectively, vitreous opacity decreased. In 29 (60.4%) patients vitreous opacities notably resolved after 1.5-2 months; in 21 (43.7%) of these patients regressive development of proliferative tissue and devastation of new vessels were observed. Visual acuity improved from 0.01-0.05 to 0.1-0.3 and stabilized at this level for 2-24 months.

No complications were observed during the early postoperative period after transscleral cryocoagulation and posterior pole scleroplasty. Vision improved 3 months after surgery in 17 (70.8%) patients, pathological process did not progress in 4 (16.6%)), deterioration was observed in 3 (12.5%)), neovascularization in the posterior pole progressed in 2, and secondary rubeous glaucoma developed in 1 patient.